What is Levitra?
Levitra (vardenafil) is a phosphodiesterase inhibitor It works by helping to relax muscles and increase blood flow into the penis during sexual stimulation This helps men to achieve and maintain an erection
Levitra is used to treat erectile dysfunction (impotence)
Levitra may also be used for purposes not listed in this medication guide

Important information about Levitra
Do not take Levitra if you are also using a nitrate drug for chest pain or heart problems (such as nitroglycerin) Taking Levitra with a nitrate medicine can cause a serious decrease in blood pressure, leading to fainting, stroke, or heart attack
During sexual activity, if you become dizzy or nauseated, or have pain, numbness, or tingling in your chest, arms, neck, or jaw, stop and call your doctor right away You could be having a serious side effect of Levitra Contact your doctor or seek emergency medical attention if your erection is painful or lasts longer than 4 hours A prolonged erection (priapism) can damage the penis
Stop using Levitra and get emergency medical help if you have sudden vision loss

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Before taking Levitra
Do not take Levitra if you are also using a nitrate drug for chest pain or heart problems This includes nitroglycerin (Nitrostat, Nitrolingual, Nitro-Dur, Nitro-Bid, and others), isosorbide dinitrate (Dilatrate-SR, Isordil, Sorbitrate), and isosorbide mononitrate (Imdur, ISMO, Monoket) Nitrates are also found in some recreational drugs such as amyl nitrate or nitrite ("poppers") Taking Levitra with a nitrate medicine can cause a serious decrease in blood pressure, leading to fainting, stroke, or heart attack
To make sure you can safely take Levitra, tell your doctor if you have any of these other conditions:
heart disease, heart rhythm disorder, history of heart attack, chest pain (angina), or congestive heart failure;
a recent history of stroke or blood clots;
a recent history (in the past 6 months) of a heart attack, angina (chest pain), or congestive heart failure;
a personal or family history of "Long QT syndrome";
high or low blood pressure;
seizures;
liver disease, kidney disease (or if you are on dialysis);
a blood cell disorder such as sickle cell anemia, multiple myeloma, or leukemia;
a bleeding disorder such as hemophilia;
kidney disease (or if you are on dialysis);
a stomach ulcer;
hearing or vision problems, history of vision loss;
an eye disorder such as retinitis pigmentosa (an inherited condition of the eye);
a physical deformity of the penis (such as Peyronie's disease); or
if you have been told you should not have sexual intercourse for health reasons
Levitra can decrease blood flow to the optic nerve of the eye, causing sudden vision loss This has occurred in a small number of people taking vardenafil, most of whom also had heart disease, diabetes, high blood pressure, high cholesterol, or certain pre-existing eye problems, and in those who smoke or are over 50 years old It is not clear whether Levitra is the actual cause of vision loss Stop using Levitra and get emergency medical help if you have sudden vision loss
FDA pregnancy category B: Although Levitra is not for use in women, this medication is not expected to be harmful to an unborn baby Although Levitra is not for use in women, it is not known if vardenafil passes into breast milk or if it could harm a nursing baby Do not use this medication without telling your doctor if you are breast-feeding a baby

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How should I take Levitra?
Take Levitra exactly as prescribed by your doctor Do not take in larger or smaller amounts or for longer than recommended Follow the directions on your prescription label
Levitra can be taken with or without food
Levitra is usually taken only when needed, about 60 minutes before sexual activity The medication can help achieve an erection when sexual stimulation occurs An erection will not occur just by taking a pill Follow your doctor's instructions
Do not take Levitra more than once a day Allow 24 hours to pass between doses Contact your doctor or seek emergency medical attention if your erection is painful or lasts longer than 4 hours A prolonged erection (priapism) can damage the penis Store at room temperature away from moisture and heat

What happens if I miss a dose?
Since Levitra is used as needed, you are not likely to be on a dosing schedule

What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222
Overdose symptoms may include back pain, muscle pain, or vision problems

What should I avoid while taking Levitra?
Drinking alcohol can increase certain side effects of Levitra
Grapefruit and grapefruit juice may interact with Levitra Discuss the use of grapefruit products with your doctor Do not increase or decrease the amount of grapefruit products in your diet without first talking to your doctor
Do not use any other drug to treat impotence, such as alprostadil (Caverject, Muse, Edex) or yohimbine (Yocon, Yodoxin, others), unless your doctor tells you to

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Levitra side effects
Stop using Levitra and get emergency medical help if you have sudden vision loss Get emergency medical help if you have any of these signs of an allergic reaction to Levitra: hives; difficulty breathing; swelling of your face, lips, tongue, or throat During sexual activity, if you become dizzy or nauseated, or have pain, numbness, or tingling in your chest, arms, neck, or jaw, stop and call your doctor right away You could be having a serious side effect of Levitra Stop using Levitra and call your doctor at once if you have any of these serious side effects:
sudden vision loss;
ringing in your ears, or sudden hearing loss;
chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling;
irregular heartbeat;
swelling in your hands, ankles, or feet;
shortness of breath;
vision changes;
feeling light-headed, fainting;
penis erection that is painful or lasts 4 hours or longer; or
seizure (convulsions)
Less serious Levitra side effects may include:
warmth or redness in your face, neck, or chest;
runny or stuffy nose;
headache, dizziness;
upset stomach; or
back pain
This is not a complete list of side effects and others may occur Call your doctor for medical advice about side effects You may report side effects to FDA at 1-800-FDA-1088

imgfeedget com/52726/link/levitra/5_headpharmacy4 html]What other drugs will affect Levitra?
Do not take Levitra if you are also using a nitrate drug for chest pain or heart problems, including nitroglycerin (Nitrostat, Nitrolingual, Nitro-Dur, Nitro-Bid, Minitran, Deponit, Transderm-Nitro), isosorbide dinitrate (Dilatrate-SR, Isordil, Sorbitrate), and isosorbide mononitrate (Imdur, ISMO, Monoket), or recreational drugs such as amyl nitrate or nitrite ("poppers")
Before taking Levitra, tell your doctor about all other medications you use for erectile dysfunction, or if you are using any of the following medications:
conivaptan (Vaprisol);
diclofenac (Arthrotec, Cataflam, Voltaren, Flector Patch, Solareze);
imatinib (Gleevec);
isoniazid (for treating tuberculosis);
an antidepressant such as nefazodone;
an antibiotic such as clarithromycin (Biaxin), dalfopristin/quinupristin (Synercid), erythromycin (E E S , EryPed, Ery-Tab, Erythrocin, Pediazole), or telithromycin (Ketek);
an antifungal medication such as itraconazole (Sporanox), ketoconazole (Nizoral), miconazole (Oravig), or voriconazole (Vfend);
drugs to treat high blood pressure or a prostate disorder, such as alfuzosin (Uroxatral), doxazosin (Cardura), prazosin (Minipress), terazosin (Hytrin), tamsulosin (Flomax);
heart or blood pressure medication such as amlodipine (Norvasc, Caduet, Exforge, Lotrel, Tekamlo, Tribenzor, Twynsta), diltiazem (Cartia, Cardizem), nicardipine (Cardene), quinidine (Quin-G), verapamil (Calan, Covera, Isoptin, Verelan);
heart rhythm medicine such as amiodarone (Cordarone, Pacerone), quinidine (Quin-G), procainamide (Procan, Pronestyl), or sotalol (Betapace); or
HIV/AIDS medicine such as atazanavir (Reyataz), delavirdine (Rescriptor), fosamprenavir (Lexiva), indinavir (Crixivan), nelfinavir (Viracept), saquinavir (Invirase), or ritonavir (Norvir, Kaletra)
This list is not complete and other drugs may interact with Levitra Tell your doctor about all medications you use This includes prescription, over the counter, vitamin, and herbal products Do not start a new medication without telling your doctor

What is Xanax?
Dr Holly takes us inside the brain to show us why depression is more than just a "down mood "
Xanax is in a group of drugs called benzodiazepines (ben-zoe-dye-AZE-eh-peens) It affects chemicals in the brain that may become unbalanced and cause anxiety
Xanax is used to treat anxiety disorders, panic disorders, and anxiety caused by depression
Xanax may also be used for other purposes not listed in this medication guide

Important information about Xanax
Do not use this medication if you are allergic to Xanax or to other benzodiazepines, such as chlordiazepoxide (Librium), clorazepate (Tranxene), diazepam (Valium), lorazepam (Ativan), or oxazepam (Serax) This medication can cause birth defects in an unborn baby Do not use Xanax if you are pregnant
Before taking Xanax, tell your doctor if you have any breathing problems, glaucoma, kidney or liver disease, or a history of depression, suicidal thoughts, or addiction to drugs or alcohol
Do not drink alcohol while taking Xanax This medication can increase the effects of alcohol
Xanax may be habit-forming and should be used only by the person it was prescribed for Xanax should never be shared with another person, especially someone who has a history of drug abuse or addiction Keep the medication in a secure place where others cannot get to it
It is dangerous to try and purchase Xanax on the Internet or from vendors outside of the United States Medications distributed from Internet sales may contain dangerous ingredients, or may not be distributed by a licensed pharmacy Samples of Xanax purchased on the Internet have been found to contain haloperidol (Haldol), a potent antipsychotic drug with dangerous side effects For more information, contact the U S Food and Drug Administration (FDA) or visit fda gov/buyonlineguide

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Before taking Xanax
Do not use this medication if you have:
narrow-angle glaucoma;
if you are also taking itraconazole (Sporanox) or ketoconazole (Nizoral); or
if you are allergic to alprazolam or to other benzodiazepines, such as chlordiazepoxide (Librium), clorazepate (Tranxene), diazepam (Valium), lorazepam (Ativan), or oxazepam (Serax)
Before taking Xanax, tell your doctor if you are allergic to any drugs, or if you have:
asthma, emphysema, bronchitis, chronic obstructive pulmonary disorder (COPD), or other breathing problems;
glaucoma;
kidney or liver disease (especially alcoholic liver disease);
a history of depression or suicidal thoughts or behavior; or
a history of drug or alcohol addiction
If you have any of these conditions, you may need a dose adjustment or special tests to safely take Xanax
FDA pregnancy category D This medication can cause birth defects in an unborn baby During pregnancy, do not take Xanax without your physician's consent Tell your doctor if you become pregnant during treatment Use an effective form of birth control while you are using this medication Xanax can pass into breast milk and may harm a nursing baby Do not use this medication without telling your doctor if you are breast-feeding a baby The sedative effects of this medication may last longer in older adults Accidental falls are common in elderly patients who take benzodiazepines Use caution to avoid falling or accidental injury while you are taking Xanax Do not give this medication to anyone under 18 years old

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How should I take Xanax?
Take Xanax exactly as it was prescribed for you Do not take the medication in larger amounts, or take it for longer than recommended by your doctor Follow the directions on your prescription label
Your doctor may occasionally change your dose to make sure you get the best results from this medication
Xanax may be habit-forming and should be used only by the person it was prescribed for Xanax should never be shared with another person, especially someone who has a history of drug abuse or addiction Keep the medication in a secure place where others cannot get to it Do not crush, chew, or break an extended-release tablet Swallow the pill whole It is specially made to release medicine slowly in the body Breaking the pill would cause too much of the drug to be released at one time
Contact your doctor if this medicine seems to stop working as well in treating your panic or anxiety symptoms
Your symptoms may return when you stop using Xanax after using it over a long period of time You may also have seizures or withdrawal symptoms when you stop using Xanax Withdrawal symptoms may include blurred vision, trouble concentrating, loss of appetite, diarrhea, muscle twitching, numbness or tingling, or increased sensations
Do not stop using Xanax suddenly without first talking to your doctor You may need to use less and less before you stop the medication completely
To be sure this medication is helping your condition, your doctor will need to check your progress on a regular basis Do not miss any scheduled visits to your doctor
Store Xanax at room temperature away from moisture, heat, and light
Keep track of how many pills have been used from each new bottle of this medicine Benzodiazepines are drugs of abuse and you should be aware if any person in the household is using this medicine improperly or without a prescription

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What happens if I miss a dose?
Take the missed dose as soon as you remember If it is almost time for your next dose, skip the missed dose and take the medicine at your next regularly scheduled time Do not take extra medicine to make up the missed dose

What happens if I overdose?
Seek emergency medical attention if you think you have used too much of this medicine An overdose of this medicine can be fatal
Xanax overdose symptoms may include extreme drowsiness, confusion, muscle weakness, loss of balance or coordination, feeling light-headed, fainting, or coma

What should I avoid while taking Xanax?
Do not drink alcohol while taking Xanax This medication can increase the effects of alcohol Xanax can cause side effects that may impair your thinking or reactions Be careful if you drive or do anything that requires you to be awake and alert
Grapefruit and grapefruit juice may interact with Xanax and lead to potentially dangerous effects Discuss the use of grapefruit products with your doctor Do not increase or decrease the amount of grapefruit products in your diet without first talking to your doctor

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What are the possible side effects of Xanax?
Get emergency medical help if you have any of these signs of an allergic reaction to Xanax: hives; difficulty breathing; swelling of your face, lips, tongue, or throat Call your doctor at once if you have any of these serious side effects:
unusual risk-taking behavior, decreased inhibitions, no fear of danger;
depressed mood, thoughts of suicide or hurting yourself;
hyperactivity, agitation, hostility, hallucinations;
feeling light-headed, fainting;
seizure (convulsions);
urinating less than usual or not at all;
muscle twitching, tremor; or
jaundice (yellowing of the skin or eyes)
Less serious Xanax side effects may include:
drowsiness, dizziness, feeling irritable;
amnesia or forgetfulness, trouble concentrating;
sleep problems (insomnia);
muscle weakness, lack of balance or coordination, slurred speech;
blurred vision;
nausea, vomiting, constipation, appetite or weight changes;
dry or watery mouth, increased sweating; or
loss of interest in sex

What other drugs will affect Xanax?
Before using Xanax, tell your doctor if you regularly use other medicines that make you sleepy (such as cold or allergy medicine, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression, or anxiety) They can add to sleepiness caused by Xanax
Before taking Xanax, tell your doctor if you are using any of the following drugs:
birth control pills;
cimetidine (Tagamet);
diltiazem (Tiazac, Cartia, Cardizem);
isoniazid (IsonaRif, Rifamate);
propoxyphene (Darvon, Darvocet);
seizure medication;
antifungal medication such as fluconazole (Diflucan), itraconazole (Sporanox) or ketoconazole (Nizoral); or
antidepressants such as fluvoxamine (Luvox), desipramine (Norpramin), or imipramine (Janimine, Tofranil)
If you are using any of these drugs, you may not be able to use Xanax, or you may need dosage adjustments or special tests during treatment
There may be other drugs not listed that can affect Xanax Tell your doctor about all the prescription and over-the-counter medications you use This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors Do not start using a new medication without telling your doctor

Soma is a muscle relaxer that works by blocking pain sensations between the nerves and the brain

Soma is used together with rest and physical therapy to treat injuries and other painful musculoskeletal conditions

Soma may also be used for other purposes not listed in this medication guide
Important information about Soma
This medication may be habit-forming and should be used only by the person it was prescribed for Soma should never be given to another person, especially someone who has a history of drug abuse or addiction Keep the medication in a secure place where others cannot get to it You may have withdrawal symptoms when you stop using Soma after using it over a long period of time Do not stop using Soma suddenly without first talking to your doctor You may need to use less and less before you stop the medication completely Soma can cause side effects that may impair your thinking or reactions Be careful if you drive or do anything that requires you to be awake and alert Avoid drinking alcohol It can increase drowsiness and dizziness caused by Soma

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Before taking Soma

Do not use Soma if you are allergic to carisoprodol or meprobamate (Equanil, Miltown), or if you have porphyria

Before using Soma, tell your doctor if you are allergic to any drugs, or if you have:
epilepsy or other seizure disorder;
liver disease; or
kidney disease
If you have any of these conditions, you may need a dose adjustment or special tests to safely take Soma
Soma may be habit-forming and should be used only by the person it was prescribed for Soma should never be given to another person, especially someone who has a history of drug abuse or addiction Keep the medication in a secure place where others cannot get to it You may have withdrawal symptoms when you stop using Soma after using it over a long period of time Withdrawal symptoms include stomach pain, sleep problems, headache, nausea, and seizure (convulsions) Do not stop using Soma suddenly without first talking to your doctor You may need to use less and less before you stop the medication completely Soma may be harmful to an unborn baby Tell your doctor if you are pregnant or plan to become pregnant during treatment It is not known whether Soma passes into breast milk or if it could harm a nursing baby Do not use this medication without telling your doctor if you are breast-feeding a baby Do not give this medication to a child younger than 12 years old

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How should I take Soma?

Take Soma exactly as it was prescribed for you Do not take the medication in larger amounts, or take it for longer than recommended by your doctor Follow the directions on your prescription label
Take each dose with a full glass of water Store Soma at room temperature away from moisture and heat

See also: Soma dosage (in more detail)
What happens if I miss a dose?

Take the missed dose as soon as you remember If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time Do not take extra medicine to make up the missed dose
What happens if I overdose?
Seek emergency medical attention if you think you have used too much of this medicine

Overdose symptoms may include shallow breathing, vision problems, fast heartbeat, confusion, hallucinations (seeing things), muscle stiffness, feeling light-headed, fainting, or seizure (convulsions)
What should I avoid while taking Soma?
Soma can cause side effects that may impair your thinking or reactions Be careful if you drive or do anything that requires you to be awake and alert Cold or allergy medicine, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression or anxiety can add to sleepiness caused by Soma Tell your doctor if you regularly use any of these other medicines Avoid drinking alcohol It can increase drowsiness and dizziness caused by Soma

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Soma side effects
Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat Stop using Soma and call your doctor at once if you have any of these serious side effects:
paralysis (loss of feeling);
extreme weakness or lack of coordination;
feeling light-headed, fainting;
fast heartbeat;
seizure (convulsions);
vision loss; or
agitation, confusion
Less serious side effects may include:
drowsiness, dizziness, tremor;
headache;
depression, feeling irritable;
blurred vision;
sleep problems (insomnia); or
nausea, vomiting, hiccups, upset stomach
This is not a complete list of side effects and others may occur Tell your doctor about any unusual or bothersome side effect

See also: Soma side effects (in more detail)
What other drugs will affect Soma?
There may be other drugs that can affect Soma Tell your doctor about all the prescription and over-the-counter medications you use This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors Do not start using a new medication without telling your doctor

What is diazepam?
Diazepam is in a group of drugs called benzodiazepines (ben-zoe-dye-AZE-eh-peens) Diazepam affects chemicals in the brain that may become unbalanced and cause anxiety
Diazepam is used to treat anxiety disorders, alcohol withdrawal symptoms, or muscle spasms It is sometimes used with other medications to treat seizures
Diazepam may also be used for purposes not listed in this medication guide

Important information about diazepam
You should not use this medication if you are allergic to diazepam or similar medicines (Ativan, Klonopin, Restoril, Xanax, and others), or if you have myasthenia gravis, severe liver disease, narrow-angle glaucoma, a severe breathing problem, or sleep apnea Do not use diazepam if you are pregnant It could harm the unborn baby
Before you take diazepam, tell your doctor if you have glaucoma, asthma or other breathing problems, kidney or liver disease, seizures, or a history of drug or alcohol addiction, mental illness, depression, or suicidal thoughts
Do not drink alcohol while taking diazepam This medicine can increase the effects of alcohol
Never take more of this medication than your doctor has prescribed An overdose of diazepam can be fatal
Diazepam may be habit-forming and should be used only by the person it was prescribed for Keep the medication in a secure place where others cannot get to it

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Before taking diazepam
Diazepam may be habit forming and should be used only by the person it was prescribed for Never share diazepam with another person, especially someone with a history of drug abuse or addiction Keep the medication in a place where others cannot get to it You should not use this medication if you are allergic to diazepam or similar drugs (Ativan, Klonopin, Restoril, Xanax, and others), or if you have:
myasthenia gravis (a muscle weakness disorder);
severe liver disease;
narrow-angle glaucoma;
a severe breathing problem; or
sleep apnea (breathing stops during sleep)
Do not give diazepam to a child younger than 6 months old
To make sure you can safely take diazepam, tell your doctor if you have any of these other conditions:
open-angle glaucoma;
asthma, emphysema, bronchitis, chronic obstructive pulmonary disorder (COPD), or other breathing problems;
kidney or liver disease;
epilepsy or other seizure disorder;
a history of mental illness, depression, or suicidal thoughts or behavior; or
a history of drug or alcohol addiction
FDA pregnancy category D Do not use diazepam if you are pregnant It could harm the unborn baby Use effective birth control, and tell your doctor if you become pregnant during treatment Diazepam may cause low blood pressure, breathing problems, or addiction and withdrawal symptoms in a newborn if the mother takes the medication during pregnancy Diazepam can pass into breast milk and may harm a nursing baby Do not use this medication without telling your doctor if you are breast-feeding a baby The sedative effects of diazepam may last longer in older adults Accidental falls are common in elderly patients who take benzodiazepines Use caution to avoid falling or accidental injury while you are taking this medicine

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How should I take diazepam?
Take diazepam exactly as prescribed by your doctor Do not take in larger or smaller amounts or for longer than recommended Follow the directions on your prescription label
Your doctor may occasionally change your dose to make sure you get the best results
Measure liquid medicine with a special dose measuring spoon or medicine cup, not with a regular table spoon If you do not have a dose measuring device, ask your pharmacist for one
Diazepam should be used for only a short time Do not take this medication for longer than 12 weeks (3 months) without your doctor's advice Do not stop using diazepam suddenly without first talking to your doctor You may have increased seizures or unpleasant withdrawal symptoms when you stop taking diazepam You may need to use less and less before you stop the medication completely Call your doctor at once if you feel that this medicine is not working as well as usual, or if you think you need to use more than usual
To be sure diazepam is not causing harmful effects, your blood may need to be tested often Your liver function may also need to be tested Visit your doctor regularly
Store diazepam at room temperature away from moisture, heat, and light
Keep track of the amount of medicine used from each new bottle Diazepam is a drug of abuse and you should be aware if anyone is using your medicine improperly or without a prescription

What happens if I miss a dose?
Take the missed dose as soon as you remember Skip the missed dose if it is almost time for your next scheduled dose Do not take extra medicine to make up the missed dose

What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222 An overdose of diazepam can be fatal
Overdose symptoms may include extreme drowsiness, loss of balance or coordination, confusion, limp or weak muscles, or fainting

What should I avoid while taking diazepam?
This medicine may impair your thinking or reactions Be careful if you drive or do anything that requires you to be alert Do not drink alcohol while taking diazepam This medication can increase the effects of alcohol

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Diazepam side effects
Get emergency medical help if you have any of these signs of an allergic reaction to diazepam: hives; difficulty breathing; swelling of your face, lips, tongue, or throat Stop using diazepam and call your doctor at once if you have a serious side effect such as:
confusion, hallucinations, unusual thoughts or behavior;
unusual risk-taking behavior, decreased inhibitions, no fear of danger;
depressed mood, thoughts of suicide or hurting yourself;
hyperactivity, agitation, aggression, hostility;
new or worsening seizures;
weak or shallow breathing;
feeling like you might pass out;
muscle twitching, tremor;
loss of bladder control; or
urinating less than usual or not at all
Less serious diazepam side effects may include:
drowsiness, tired feeling;
memory problems;
dizziness, spinning sensation;
feeling restless or irritable;
muscle weakness;
nausea, constipation;
drooling or dry mouth, slurred speech;
blurred vision, double vision;
mild skin rash, itching; or
loss of interest in sex
This is not a complete list of side effects and others may occur Call your doctor for medical advice about side effects You may report side effects to FDA at 1-800-FDA-1088

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What other drugs will affect diazepam?
Before taking diazepam, tell your doctor if you regularly use other medicines that make you sleepy (such as cold or allergy medicine, other sedatives, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression, or anxiety) They can add to sleepiness caused by diazepam
Tell your doctor about all other medicines you use, especially:
cimetidine (Tagamet);
omeprazole (Prilosec);
phenytoin (Dilantin);
an antibiotic such as clarithromycin (Biaxin), dalfopristin/quinupristin (Synercid), erythromycin (E E S , EryPed, Ery-Tab, Erythrocin, Pediazole), or telithromycin (Ketek);
an antidepressant such as fluoxetine (Prozac, Sarafem) or fluoxetine (Prozac, Sarafem, Symbyax), and others;
antifungal medicine such as itraconazole (Sporanox), ketoconazole (Extina, Ketozole, Nizoral, Xolegal), miconazole (Oravig), or voriconazole (Vfend);
heart or blood pressure medication such as amlodipine (Norvasc, Caduet, Exforge, Lotrel, Tekamlo, Tribenzor, Twynsta), diltiazem (Cartia, Cardizem), nicardipine (Cardene), quinidine (Quin-G), verapamil (Calan, Covera, Isoptin, Verelan), and others; or
HIV/AIDS medicine such as atazanavir (Reyataz), delavirdine (Rescriptor), fosamprenavir (Lexiva), indinavir (Crixivan), nelfinavir (Viracept), saquinavir (Invirase), or ritonavir (Norvir, Kaletra)
This list is not complete and other drugs may interact with diazepam Tell your doctor about all medications you use This includes prescription, over-the-counter, vitamin, and herbal products Do not start a new medication without telling your doctor

What is Ultram?
Ultram (tramadol) is a narcotic-like pain reliever
Ultram is used to treat moderate to severe pain Ultram extended-release is used to treat moderate to severe chronic pain when treatment is needed around the clock
Ultram may also be used for other purposes not listed in this medication guide

Important information about Ultram
You should not take Ultram if you are allergic to tramadol, if you have ever been addicted to drugs or alcohol, or if you have ever attempted suicide Do not take Ultram while you are intoxicated (drunk) or taking any of the following: alcohol or street drugs, narcotic pain medicine, sedatives or tranquilizers, or medicine for depression, anxiety, or mental illness
Seizures (convulsions) have occurred in some people taking this medication Ultram may be more likely to cause a seizure if you have a history of seizures or head injury, a metabolic disorder, or if you are taking certain medicines such as antidepressants, muscle relaxers, narcotic, or medicine for nausea and vomiting
Seek emergency medical attention if you think you have used too much of this medicine An Ultram overdose can be fatal
Ultram may be habit-forming Tell your doctor if you feel the medicine is not working as well in relieving your pain Never share Ultram with another person, especially someone with a history of drug abuse or addiction Keep the medication in a place where others cannot get to it
Do not crush an Ultram tablet Ultram is for oral (by mouth) use only Powder from a crushed tablet should not be inhaled or diluted with liquid and injected into the body Using this medicine by inhalation or injection can cause life-threatening side effects, overdose, or death

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Before taking Ultram
You should not take Ultram if you are allergic to tramadol, if you have ever been addicted to drugs or alcohol, or if you have ever attempted suicide
Do not take Ultram while you are intoxicated (drunk) or taking any of the following:
alcohol or street drugs;
narcotic pain medicine;
sedatives or tranquilizers (such as Valium);
medicine for depression or anxiety; or
medicine for mental illness (such as bipolar disorder, schizophrenia)
Seizures have occurred in some people taking Ultram Talk with your doctor about your seizure risk, which may be higher if you have:
a history of drug or alcohol addiction;
a history of epilepsy or other seizure disorder;
a history of head injury;
a metabolic disorder; or
if you are also taking an antidepressant, muscle relaxer, narcotic, antipsychotic, or medicine for nausea and vomiting
To make sure you can safely take Ultram, tell your doctor if you have any of these other conditions:
kidney disease (or if you are on dialysis);
cirrhosis or other liver disease;
a stomach disorder; or
a history of depression, mental illness, or thoughts of suicide
FDA pregnancy category C It is not known whether Ultram will harm an unborn baby Ultram may cause serious or fatal side effects in a newborn if the mother uses this medication during pregnancy or labor Tell your doctor if you are pregnant or plan to become pregnant while using Ultram Tramadol can pass into breast milk and may harm a nursing baby You should not breast-feed while you are taking Ultram Do not give this medication to anyone younger than 16 years old without the advice of a doctor

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How should I take Ultram?
Take Ultram exactly as prescribed Never take Ultram in larger amounts, or for longer than recommended by your doctor Follow the directions on your prescription label Tell your doctor if the medicine seems to stop working as well in relieving your pain
Ultram can be taken with or without food, but take it the same way each time
Do not crush, chew, or break an Ultram ER tablet Swallow the tablet whole Breaking the tablet may cause too much tramadol to be released at one time This medicine is for oral (by mouth) use only Powder from a crushed tablet should not be inhaled or diluted with liquid and injected into the body Using this medicine by inhalation or injection can cause life-threatening side effects, overdose, or death
If you use the Ultram extended-release tablet, the tablet shell may pass into your stools (bowel movements) This is normal and does not mean that you are not receiving enough of the medicine
Ultram may be habit-forming Never share Ultram with another person, especially someone with a history of drug abuse or addiction Do not stop using Ultram suddenly, or you could have unpleasant withdrawal symptoms Talk to your doctor about how to avoid withdrawal symptoms when stopping the medication
Store Ultram at room temperature away from moisture and heat Keep track of the amount of medicine used from each new bottle Ultram is a drug of abuse and you should be aware if anyone is using your medicine improperly or without a prescription

What happens if I miss a dose?
Take the missed dose as soon as you remember Skip the missed dose if it is almost time for your next scheduled dose Do not take extra medicine to make up the missed dose

What should I avoid while taking Ultram?
Do not drink alcohol It may cause a dangerous decrease in your breathing when used together with tramadol Ultram may impair your thinking or reactions Be careful if you drive or do anything that requires you to be alert

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Ultram side effects
Get emergency medical help if you have any of these signs of an allergic reaction to Ultram: hives; difficulty breathing; swelling of your face, lips, tongue, or throat Stop using Ultram and call your doctor at once if you have any of these serious side effects:
agitation, hallucinations, fever, fast heart rate, overactive reflexes, nausea, vomiting, diarrhea, loss of coordination, fainting;
seizure (convulsions);
a red, blistering, peeling skin rash; or
shallow breathing, weak pulse
Less serious Ultram side effects may include:
dizziness, spinning sensation;
constipation, upset stomach;
headache;
drowsiness; or
feeling nervous or anxious
This is not a complete list of side effects and others may occur Call your doctor for medical advice about side effects You may report side effects to FDA at 1-800-FDA-1088

What other drugs will affect Ultram?
You may be more likely to have a seizure (convulsions) if you take Ultram while you are using certain other medicines Do not take Ultram without telling your doctor if you also use any of the following medications:
an MAO inhibitor such as isocarboxazid (Marplan), tranylcypromine (Parnate), phenelzine (Nardil), or selegiline (Eldepryl, Emsam); or
an antidepressant such as amitriptyline (Elavil, Vanatrip), citalopram (Celexa), clomipramine (Anafranil), desipramine (Norpramin), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), imipramine (Tofranil), nortriptyline (Pamelor), paroxetine (Paxil), or sertraline (Zoloft)
Cold or allergy medicine, sleeping pills, muscle relaxers, and medicine for seizures or anxiety can add to sleepiness caused by Ultram Tell your doctor if you regularly use any of these medicines, or any other pain medication
Tell your doctor about all other medicines you use, especially:
carbamazepine (Tegretol);
lithium (Eskalith, LithoBid);
ADHD medications (Adderall, Ritalin, Strattera);
an antibiotic such as clarithromycin (Biaxin), erythromycin (E E S , EryPed, Ery-Tab, Erythrocin), linezolid (Zyvox), rifampin (Rifadin, Rimactane, Rifater); or telithromycin (Ketek);
antifungal medication such as clotrimazole (Mycelex Troche), itraconazole (Sporanox), ketoconazole (Extina, Ketozole, Nizoral, Xolegal), or voriconazole (Vfend);
cancer medications such as gefitinib (Iressa), imatinib (Gleevec), or nilotinib (Tasigna);
a heart rhythm medication such as amiodarone (Cordarone, Pacerone), flecainide (Tambocor), propafenone (Rythmol), or quinidine (Quin-G);
heart or blood pressure medication such as diltiazem (Cartia, Cardizem), felodipine (Plendil), nifedipine (Nifedical, Procardia), verapamil (Calan, Covera, Isoptin, Verelan), and others;
HIV/AIDS medicine such as atazanavir (Reyataz), delavirdine (Rescriptor), fosamprenavir (Lexiva), indinavir (Crixivan), nelfinavir (Viracept), saquinavir (Invirase), or ritonavir (Norvir, Kaletra); or
migraine headache medicine such as sumatriptan (Imitrex, Treximet)
This list is not complete and there are many other drugs that can interact with Ultram Tell your doctor about all medications you use This includes prescription, over-the-counter, vitamin, and herbal products Do not start a new medication without telling your doctor Keep a list of all your medicines and show it to any healthcare provider who treats you

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